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On behalf of the ASA Task Force on Management of the Difficult Airway and the ASA Committee on Standards and Practice Parameters, we thank Dr. Gayes for his thoughtful letter to the editor. Dr. Gayes reminds us that the position of the patient’s head can be part of a preplanned strategy for management of a known or suspected difficult airway.

Dr. Gayes poses a specific question – why is head position not mentioned as a preplanned strategy in the ASA Difficult Airway Guidelines? The straightforward answer to this question is that the inclusion of head position was not identified as a priority during the development of the original difficult airway guidelines or the recent revision. Dr. Gayes suggests that proper head position may be viewed by some practitioners as an intuitive concept. In part, this may explain why task force members, consultants, open forum attendees and survey participants did not call for the inclusion of head position as a specifically described element of the difficult airway guidelines.